1. Non-invasive ventilation in obesity hypoventilation syndrome without severe obstructive sleep apnoea
- Author
-
Masa, Juan F, Corral, Jaime, Caballero, Candela, Barrot, Emilia, Terán-Santos, Joaquin, Alonso-Álvarez, Maria L, Gomez-Garcia, Teresa, González, Mónica, López-Martín, Soledad, De Lucas, Pilar, Marin, José M, Marti, Sergi, Díaz-Cambriles, Trinidad, Chiner, Eusebi, Egea, Carlos, Miranda, Erika, Mokhlesi, Babak, Spanish Sleep Network, García-Ledesma, Estefanía, Sánchez-Quiroga, M-Ángeles, Ordax, Estrella, González-Mangado, Nicolás, Troncoso, Maria F, Martinez-Martinez, Maria-Ángeles, Cantalejo, Olga, Ojeda, Elena, Carrizo, Santiago J, Gallego, Begoña, Pallero, Mercedes, Ramón, M Antonia, Díaz-de-Atauri, Josefa, Muñoz-Méndez, Jesús, Senent, Cristina, Sancho-Chust, Jose N, Ribas-Solís, Francisco J, Romero, Auxiliadora, Benítez, José M, Sanchez-Gómez, Jesús, Golpe, Rafael, Santiago-Recuerda, Ana, Gomez, Silvia, and Bengoa, Mónica
- Subjects
Non-Invasive Ventilation ,Pulmonary and Respiratory Medicine ,Spirometry ,Male ,medicine.medical_specialty ,Partial Pressure ,Polysomnography ,Vital Capacity ,Blood Pressure ,03 medical and health sciences ,Sleep apnoea ,0302 clinical medicine ,Quality of life ,Forced Expiratory Volume ,Obesity Hypoventilation Syndrome ,medicine ,Humans ,030212 general & internal medicine ,Prospective cohort study ,Intensive care medicine ,Life Style ,Aged ,Obesity hypoventilation syndrome ,Aged, 80 and over ,Sleep Apnea, Obstructive ,Noninvasive Ventilation ,medicine.diagnostic_test ,business.industry ,Non invasive ventilation ,Carbon Dioxide ,Middle Aged ,medicine.disease ,respiratory tract diseases ,Respiratory Function Tests ,Clinical trial ,Blood pressure ,Treatment Outcome ,030228 respiratory system ,Emergency medicine ,Arterial blood ,Female ,Respiratory Insufficiency ,business - Abstract
Background Non-invasive ventilation (NIV) is an effective form of treatment in patients with obesity hypoventilation syndrome (OHS) who have concomitant severe obstructive sleep apnoea (OSA). However, there is a paucity of evidence on the efficacy of NIV in patients with OHS without severe OSA. We performed a multicentre randomised clinical trial to determine the comparative efficacy of NIV versus lifestyle modification (control group) using daytime arterial carbon dioxide tension (PaCO2) as the main outcome measure. Methods Between May 2009 and December 2014 we sequentially screened patients with OHS without severe OSA. Participants were randomised to NIV versus lifestyle modification and were followed for 2 months. Arterial blood gas parameters, clinical symptoms, health-related quality of life assessments, polysomnography, spirometry, 6-min walk distance test, blood pressure measurements and healthcare resource utilisation were evaluated. Statistical analysis was performed using intention-to-treat analysis. Results A total of 365 patients were screened of whom 58 were excluded. Severe OSA was present in 221 and the remaining 86 patients without severe OSA were randomised. NIV led to a significantly larger improvement in PaCO2 of −6 (95% CI −7.7 to −4.2) mm Hg versus −2.8 (95% CI −4.3 to −1.3) mm Hg, (p
- Published
- 2016